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Nearly 420 extra GPs needed across country to deliver A&E streaming service

Exclusive The NHS may need to find an extra 400 GPs to deliver the Government’s pledge to put a GP streaming service in every A&E department, Pulse can reveal.

NHS England has said ‘every hospital’ should implement a ‘comprehensive front-door streaming model by October 2017’ which should be up and running ‘by Christmas’.

Health secretary Jeremy Hunt said this comes as the system is working ‘spectacularly at hospitals like Luton and Dunstable’, which were able to admit or discharge 95% of its patients within four hours this winter despite mounting pressures.

But Pulse has learned that Luton and Dunstable University Hospital employs two to three GPs every day of the year and if the model is rolled out nationwide to the 139 trusts with major A&E departments, between 278 and 417 GPs would need to be working in A&Es on any one day.

This comes as official figures revealed last month that the equivalent of over 400 full-time GPs left the workforce in the last three months of 2016.

GPC deputy chair Dr Richard Vautrey said the plans ‘run counter’ to the Government’s pledge to expand general practice, and GPC workforce lead Dr Krishna Kasaraneni said it was ‘doubtful’ the plan was feasible.

The Government’s Spring Budget pledged £100m towards the scheme, which the DH will be distributing to around 100 A&E units based on NHS England and NHS Improvement recommendations.

The investment will be transferred to the department’s budget for 2017/18, but will not increase the baseline budget in subsequent years, the DH said.

When asked for more details on how the scheme would be staffed, the DH reiterated that it was ‘already working in Luton and Dunstable Hospital’.

The spokesperson added: ‘As part of our plans, we want to see more of our excellent GPs in urgent and emergency care, helping patients to get the right treatment, whilst making the best use of staff time.’

But Dr Vautrey said that having a GP in A&E who will be expected to see patients within four hours ‘will simply draw in more inappropriate hospital attendances’ as the shortage of GPs is causing ‘longer and longer waiting times’ in GP practices.

He said: ‘NHS England has stated that it intended to invest preferentially in general practice rather than hospitals, and yet this policy runs counter to that and risks making the same mistakes as have been made in the past when the creation of walk-in-centres just fuelled demand and became unaffordable.’

And Dr Kasaraneni added: ‘Given this chronic lack of GPs, it is doubtful enough will be available to staff triage services in hospitals and most importantly we actually need more GPs in local surgeries.

‘The Government should be focusing on this as a priority because we cannot soldier on with an understaffed GP service that is unable to provide enough appointments to patients.’

NHS England declined to comment.

The Luton and Dunstable GP streaming model

The hospital has a co-located urgent GP centre, which is open from 8am to midnight, every day of the year.

Between two and three GPs work in the centre daily, with a minimum of two GPs working there at any one time.

The GPs at the centre see an average 120 patients a day.

The trust did not provide Pulse with information on the cost of running the centre.

Source: Luton and Dunstable NHS Foundation Trust